Abstract Details

Title Novel Technique of Stent Placement via Gateway Balloon in Intracranial Atherosclerosis-associated Large Vessel Occlusion

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-019

Background The Food and Drug administration (FDA) approved Wingspan Stent used in ICAD-LVO cases requires micro catheter exchange maneuver which is associated with complications such as intracranial hemorrhage (ICH). Neuroform Atlas stent can be deployed directly via Gateway Balloon for angioplasty and stent placement without the need for exchange maneuver, potentially reducing the risk of complications due to vascular trauma.

Objective To present our initial experience of deploying Neuroform Atlas stent directly via Gateway Balloon Catheter in intracranial atherosclerosis disease-associated large vessel occlusions (ICAD-LVO).

Design/Methods Patients were identified through mechanical thrombectomy database from January 2020 to June 2022 at our institutions. Due to reocclusion or impending occlusion, rescue angioplasty with stent placement was performed after initial standard MT. Primary outcomes were good angiographic recanalization with modified thrombolysis in cerebral infarction (mTICI) score of 2b-3, rate of intracranial hemorrhage (ICH), and favorable functional outcome at 3 months, that is, modified Rankin Scale (mRS) score of 0-3.

Results We identified 22 patients treated using this technique. Among those, 11 were females with their average age at 66 years (range: 52-85). Initial median National Institute of Health Stroke Scale score was 11 (range: 5-30) and all patients received loading doses of aspirin and P2Y12 inhibitor. After performing submaximal angioplasty and Neuroform Atlas stent deployment through the gateway balloon, we achieved final mTICI of 2b-3 in 20 (90%) patients. One patient had ICH post-op that was asymptomatic. Eight (36%) patients had mRS of 0-3 at 90 days.

Conclusions Our preliminary experience suggests possible safety and feasibility of deploying Neuroform Atlas stent through a compatible Gateway Balloon Catheter without the need for ICH-associated micro catheter exchange. Multi-center prospective clinical trials with long-term clinical and angiographic follow-up are warranted to confirm this favorability.

Authors/Disclosures
Rowaid Ahmad, MBBS PRESENTER	Dr. Ahmad has nothing to disclose.
Muhammad Z. Memon, MD (UTMB)	Dr. Memon has nothing to disclose.
Mohamad Ezzeldin, MD (Rush University Medical Center)	Dr. Ezzeldin has nothing to disclose.
Arundhati Biswas	No disclosure on file
Taha Nisar, MD (Rutgers New Jersey Medical School)	Dr. Nisar has nothing to disclose.
Amit Singla	No disclosure on file
Nazar Muhammad	No disclosure on file
Hashem Shaltoni, MD	Dr. Shaltoni has nothing to disclose.
Peter Kan	No disclosure on file
Osama O. Zaidat, MD, FAAN (Neuroscience and Stroke Medical Director St Vincent Mercy Hospital)	Dr. Zaidat has nothing to disclose.
Priyank Khandelwal, MD	Dr. Khandelwal has nothing to disclose.